Percutaneous vascular procedures are performed in many vessels in the body, including, for example, the coronary arteries, saphenous vein grafts, carotid arteries, cerebral vessels, and peripheral vessels. These procedures generally require the physician to gain access to the target vessel with a guiding catheter or sheath and track a guidewire into the vessel past a lesion or other location for the performance of a treatment procedure. One common complication of percutaneous procedures is the inability to gain access to a vessel and thus to properly position the interventional devices past the target position. Anatomical variations, such as lesion size and morphology, vessel tortuosity, and vessel take off angle contribute to these complications. Additional factors, such as poor guide support, can further lead to crossing issues. These complications can be compounded when the patient has previously received a stent, when the target lesion is located at a bifurcation, or when the patient has a chronic total occlusion where the vessel is completely or almost completely blocked.